In The News

• Decreasing dietary sodium intake most likely reduces blood pressure in normotensive adults and more so in those with hypertension
• Higher sodium intake may be associated with greater risk for developing hypertension
• Use of potassium-containing salt-substitutes in the diet to reduce sodium intake most likely reduces blood pressure in adults
• Increasing potassium intake most likely decreases blood pressure in adults with hypertension
• All-cause mortality may be associated with sodium intake
• Reduced sodium intake may decrease the risk for combined CVD morbidity and mortality

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The 21st Century Cures Act (P.L. 114-255) is landmark, bipartisan legislation that was signed into law on Dec. 13, 2016, and touches virtually all aspects of biomedical research, medical product development and the regulatory approval process. Read what FasterCures has said about 21st Century Cures over the years.

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Evidence Review Now Available

Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review
(Systematic Review, released on June 11, 2018)

Selected Key Messages:
- Interventions that improved function and/or pain for at least 1 month when used for—

• Chronic low back pain: Exercise, psychological therapies (primarily cognitive behavioral therapy [CBT]), spinal manipulation, low-level laser therapy, massage, mindfulness-based stress reduction, yoga, acupuncture, multidisciplinary rehabilitation (MDR).
• Chronic neck pain: Exercise, low-level laser, Alexander Technique, acupuncture.
• Knee osteoarthritis: Exercise, ultrasound.
• Hip osteoarthritis: Exercise, manual therapies.
• Fibromyalgia: Exercise, CBT, myofascial release massage, tai chi, qigong, acupuncture, MDR.
• Chronic tension headache: Spinal manipulation.

- Most effects were small. Long-term evidence was sparse.

- There was no evidence suggesting serious harms from any of the interventions studied; data on harms were limited.

For more, see: https://effectivehealthcare.ahrq.gov/topics/nonpharma-treatment-pain/research-2018

App offers easy access to scientifically backed information on herbs and herbal products.

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What health care decisions are you struggling with? Would a review of the scientific evidence help inform this decision? Share your ideas with the Agency for Healthcare Research and Quality’s (AHRQ) Evidence-based Practice Center (EPC) Program. AHRQ will use these ideas to determine the focus of its evidence reports for next fiscal year (i.e., AHRQ can provide an evidence report at no cost). Your input is important!

Propose your evidence report topics by June 22 at:
https://www.effectivehealthcare.ahrq.gov/index.cfm/submit-a-suggestion-for-research/.

The AHRQ EPC Program reviews and summarizes the available evidence on current health care issues, which can help:

• Clinicians and policymakers understand the benefits and harms of different tests and treatments;
• Health systems and policymakers understand the best options for implementing a new program or intervention; and
• Patients make better decisions about their health care options;

Consistent with past years, we will review every proposed topic with our selection criteria (https://effectivehealthcare.ahrq.gov/about/epc/nomination/). Information about the importance and impact of a review will especially be helpful. In particular, the potential impact of a review on clinical practice and health outcomes --- going beyond a guideline or recommendation.

If you have any questions, please contact epc@ahrq.hhs.gov

Findings show the impact of chronic pain on the brain and its relation to depression.

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The AHRQ National Guideline Clearinghouse (NGC, guideline.gov) Web site will not be available after July 16, 2018 because federal funding through AHRQ will no longer be available to support the NGC as of that date. AHRQ is receiving expressions of interest from stakeholders interested in carrying on NGC's work. It is not clear at this time, however, when or if NGC (or something like NGC) will be online again. In addition, AHRQ has not yet determined whether, or to what extent, the Agency would have an ongoing role if a stakeholder were to continue to operate the NGC. We will continue to post summaries of new and updated evidence-based clinical practice guidelines until July 2, 2018. For any questions, please contact Mary.Nix@ahrq.hhs.gov.

Results from an international clinical trial of more than 4880 participants, published in the New England Journal of Medicine, show that combining clopidogrel and aspirin following a small stroke or experiencing minor stroke symptoms decreases risk of a new stroke, heart attack or other ischemic event within 90 days.  The combination therapy was also associated with an increase in major bleeding, although many of those episodes were non-fatal and did not occur in the brain. The results were presented at the 4^th European Stroke Organization Conference in Gothenburg, Sweden. The study was supported by the NIH’s National Institute of Neurological Disorders and Stroke (NINDS).

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A new AHRQ report found that, although consumers have access to hundreds of smart phone apps for diabetes management, only 11 had been researched, and only five were associated with clinically significant improvements in levels of blood sugar control as measured by hemoglobin A1c (HbA1c) tests. Researchers sought to understand apps’ effectiveness to support self-management of type 1 and type 2 diabetes. A small number of apps were shown to provide benefits beyond A1c control, such as reducing episodes in which blood sugar levels register too high or too low. An article based on the evidence review was published in the Journal of General Internal Medicine. Access the abstract or AHRQ’s press release.

AHRQ’s updated Guide to Improving Patient Safety in Primary Care Settings by Engaging Patients and Families features strategies for patients and families, clinicians and primary care clinical staff to improve communication.

Evidence suggests that enhanced communication leads to significant improvements in patient safety, the quality of care and patient experiences. The guide also features advice from practices from across the country that implemented the interventions.

Access the guide.